UMass Memorial, Harrington reach deal on psych beds

Saturday

May 20, 2017 at 5:46 PMMay 20, 2017 at 10:42 PM

By Cyrus Moulton Telegram & Gazette Staff

UMass Memorial Medical Center announced a formal agreement with Harrington Healthcare to provide inpatient psychiatric services and will offer a twice-daily shuttle among various hospitals, in response to state Department of Public Health concerns about plans to close 13 inpatient psychiatric beds at the medical center’s University Campus.

But the medical center still plans to close the beds according to schedule.

"In recognition of the importance of the issues and in response to your request [to reassess its proposed date for closure of the beds on June 1, 2017] the Medical Center has reviewed and reassessed its plan in full consideration of the concerns stated in your letter," Andrew S. Levine, a lawyer with the Boston firm of Donoghue, Barrett, & Singal, wrote on behalf of the hospital in a May 18 letter to the DPH. "After careful consideration of these issues, the Medical Center has concluded that notwithstanding the closure of 13 beds on June 1, 2017, patient access to behavioral health services can be maintained in the central Massachusetts area."

In January, management at UMMC announced plans to close 13 of the 27 psychiatric beds on 8 East, the busy inpatient psychiatric unit at the University Campus, and convert those beds to medical/surgical beds. The hospital said there is a need for medical/surgical beds for the region’s only major trauma center.

The planned closing, however, is opposed by the Massachusetts Nurses Association, which represents nurses at UMass Memorial, and by mental health advocates and the Worcester City Council. Attendees at a March 30 public hearing also assailed the plan.

In an April 17 letter, the DPH found "the services provided by the Hospital are in fact necessary for preserving access and health status within the Hospital’s service area." The DPH, which cannot technically stop the hospital from its plan but can raise concerns and request information, asked the hospital to submit a plan detailing how access to psychiatric care will be maintained, as well as address issues raised during the March 30 public hearing.

In an April 28 response, the hospital, estimating that an average of 1.2 patients per day will need to be transferred to alternative sites, said that it and other area hospitals will be able to meet the demand posed by the closing of the 13 inpatient psychiatric beds. The medical center cited four new sites in the Central Massachusetts area with new or proposed new psychiatric beds. The medical center proposed a two-day-a-week shuttle service between the University Campus and TaraVista Behavioral Health Center in Devens, with which it has a formal affiliation agreement for 14 beds.

The DPH responded in a May 8 letter that the plan "does not adequately meet the needs of the patients in the community" and asked the hospital to delay the closure. The DPH cited concerns that the beds at other facilities would not be available at the time the UMMC beds closed.

The medical center responded in a five-page letter Thursday.

The medical center said that beds at alternative hospitals will be ready "at approximately the same time that the Medical Center closes 13 beds."

UMass Memorial said that Westboro Behavioral Healthcare Hospital is in an existing building and "is preparing to open in early August," while TaraVista Behavioral Healthcare in Devens is "in the process of expanding its capacity to 54 beds in mid-June."

But "most importantly," according to the letter, Harrington Hospital in Southbridge and Webster has, on average, eight to 10 open beds per day. Harrington has two behavioral health units: a 14-bed unit at its main campus in Southbridge, and a 16-bed unit in Webster.

In a statement accompanying the letter, UMMC said that it was announcing "the start of a formal relationship between the Medical Center and Harrington Healthcare to provide inpatient psychiatric services on their campuses."

The hospital will participate in the daily bed huddle to locate beds for patients in need of transfer, the hospital told the DPH.

"On a daily basis, Harrington Healthcare has a combined average of 8-10 open beds available to take care of behavioral health patients, including those patients needing medical support," UMMC Spokesman Anthony Berry said in the statement. "When coupled with the 14 beds we previously formalized with TaraVista, we are extremely confident in the ability of hospitals in Central Massachusetts to care for patients in need of psychiatric services."

The hospital also revised its transportation plan in response to DPH concerns, announcing a twice-a-day shuttle among TaraVista, Harrington Hospital sites and the Westboro facility. The shuttle will run for a six-month period, during which time it will be assessed, according to the letter and UMMC statement.

David Schildmeier, director of public communications for the Massachusetts Nurses Association, said the hospital still had given no “medical or ethical justification” for its “callous decision” to close the psychiatric beds.

“Nobody outside of UMass who is investigating this issue has come to the conclusion that this plan makes any sense,” Schildmeier said.

He said the hospital has 45 medical/surgical beds available on the Memorial campus which could be opened to care for medical patients.

The Department of Public Health said it is “currently reviewing the information that has been provided and will continue to monitor the implementation of the hospital’s plan to ensure the preservation of access and health status in the hospital’s service area.”

The hospital’s response is the last formal step in the essential services process.

"The agreements with Harrington Healthcare and TaraVista present a unique opportunity to have a solution in place that is responsive to Mass DPH and also addresses the long-term critical need for additional medical-surgical beds as part of our mission to serve all patients in Central Massachusetts — many of whom rely heavily on our safety net hospital and emergency department," the hospital's statement read. "We respect all points of view on what is a challenging issue and will continue to work with the Mass DPH and other interested parties even after the essential services process officially ends."